Biomedical subjects
Publications and source records attributed to J B Sloan.
Eccrine syringofibroadenoma (acrosyringeal nevus) is a rare tumor of proliferating ductular structures resembling the acral portion of the eccrine duct. Our case describes a histologic variant showing nests of periodic acid Schiff-positive clear cells resembling the clear-cell variant of eccrine syringoma.
BACKGROUND: Seborrheic keratoses have on rare occasion been reported to undergo malignant transformation. OBJECTIVE: Our purpose was to examine the incidence and distribution of squamous cell carcinomas (SCCs) in situ arising in clinically banal-appearing seborrheic keratoses. METHODS: We prospectively selected such cases over a 6-month period of time from routinely accessioned specimens to a dermatopathology service. RESULTS: We found 1.4% of clinically diagnosed seborrheic keratoses to be SCCs in situ. These lesions were more common in elderly persons and were more likely to occur on the head and neck, suggesting the role of cumulative sun damage in the transformation of such lesions. CONCLUSION: Malignant transformation of seborrheic keratoses, although rare, appears to occur more frequently in the elderly on the head and neck. Because this change is not necessarily accompanied by clinically discernable changes, more careful scrutiny of such lesions may be of therapeutic rather than cosmetic significance in this population.
An unusual variant of malignant pilomatrixoma displaying melanization of epithelial elements is described. Melanization is a rare event even in the benign form of this adnexal neoplasm. Previously reported cases of malignant pilomatrixoma are reviewed; none containing pigment have been previously reported to our knowledge. Possible etiologies for lack of pigment in most benign and malignant pilomatrixoma are discussed.
Transrectal prostate ultrasound is helpful as an adjunct in monitoring prostate balloon dilatation using the ASI system. This is a review of the important features of this technique.
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We report two patients with segmental neurofibromatosis and review the literature with regard to possible hereditary transmission of this disorder. Patients that meet strict criteria for the diagnosis of segmental neurofibromatosis seem to have a low probability of transmitting the disease. We emphasize the importance of establishing and strictly adhering to a set of diagnostic criteria and of obtaining a comprehensive family history when reporting cases of segmental neurofibromatosis.
Papulonecrotic tuberculid is a rare cutaneous manifestation of tuberculosis that can also be associated with other mycobacteria. Clinically, it is an asymptomatic, recurrent eruption of papules with a necrotic center in a symmetric, acral distribution. Tubercle bacilli are not present in skin biopsies. The eruption resolves promptly with antituberculoid therapy. Few patients with this entity have been reported in the United States over the last 50 years. We report a 9-year-old, otherwise healthy, American girl whose sole initial findings were lesions of papulonecrotic tuberculid secondary to Mycobacterium tuberculosis.
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The occurrence of both lupus erythematosus and multiple sclerosis in several members within the same family has been previously documented. In the past, patients manifesting symptoms and findings compatible with both of these diseases have posed difficult diagnostic problems. This report concerns a patient with long-standing multiple sclerosis and in whom cutaneous and serologic lupus erythematosus developed. To our knowledge this is the first such case reported in the English literature. A daughter of this patient had developed serologic lupus erythematosus. The intensified study of patients with both of these diseases and those families with several members with one of these diseases may lead to new insights into the cause and pathogenesis of these disorders.
Multiple sclerosis (MS) and systemic lupus erythematosus (SLE) have overlapping clinical features and laboratory findings. It has, in fact, been hypothesized that MS and SLE have a common etiology. Usually MS and SLE are considered to have autoimmune pathogenesis, and both are chronic diseases that can respond to steroids. Some patients are diagnosed with either MS or SLE but subsequently develop the other disease. We described a family where multiple members of one generation have SLE and two members of the preceding generation have MS. Histocompatibility typing did not reveal any association between HLA inheritance of genes and incidence of severity of disease.
Iontophoresis, the process of increasing the penetration of drugs into surface tissues by the application of an electric current, has been applied to a great many disease conditions over its 200-year history. Although its greatest success has been in the treatment of hyperhidrosis, it is steadily finding new applications. Many aspects of the mechanisms of iontophoresis have yet to be studied before the technic is both fully understood and maximally utilized. In this article we review the literature on iontophoresis as it pertains to dermatology, including the basic principles, engineering aspects.
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When Escherichia coli 15T- cells growing exponentially at 70- to 80-min doubling times are subjected to a nutritional shift-up via glucose addition, cell division continues at the preshift rate for about 70 min (rate maintenance). The same cells growing at doubling times of 120 min or longer, however, begin to divide at a new faster rate immediately upon glucose addition. In both the rate maintenance and immediate division situations, cell mass, as measured by optical density (OD), begins to increase immediately upon shift-up. Consequently, the OD/cell pattern differs in the two growth-rate transitions. During rate maintenance, the OD/cell ratio increases dramatically for 60 to 70 min, and then slows appreciably and approaches the OD/cell characteristic of the new medium. During immediate division situations, the OD/cell increases only slightly for the first 180 +/- min; then the rate of increase accelerates but does not stop at the OD/cell characteristic of the new medium. Immediate division upon nutritional shift-up apparently depends upon initial doubling times in excess of 115 to 120 min and provision of a readily metabolized carbon source supporting doubling times of about 40 min. Similar immediate division occurs in E. coli B/r and K-12.
A case of acute lymphocytic leukemia is described with bilateral ocular involvement, including iris, trabecular meshwork, and anterior chamber. Microscopic findings are correlated with clinical findings. All cases reported to date (5) in the American literature with microscopically confirmed leukemic iris infiltrate have been of acute lymphocytic leukemia.
Innovar, administered intramuscularly 45 minutes preoperatively, provides excellent operative sedation, analgesia, and patient cooperation. Postoperative complications are minimized, and the quantity of postoperative analgesics and antiemetics is drastically reduced when Innovar is used as a preoperative medication.
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